What I talk about in my daily neurology team rounds

A manifest checklist

We had a few near misses and annoyed team members the last weeks, so we did some probing, asked around and tried to identify what went wrong. It turns out – as so often – that team communication had deteriorated over the last months, so that the various members did not understand eachother anymore. This led to exchanges about our communication culture and to the project of a team timeout with a stroke team “preflight checklist” that we go through for each patient in the morning:

What is the disease of the patient?

Is he stable?

What is the plan for today?

Are all drugs ordered and ready?

Have all labs been drawn?

Is there any impediment to mobilization or oral nutrition?

We learned a lot from projects like the Provonost study and the surgical safety checklist. As far as I understand the author of “The checklist manifesto” – a Brigham and Women’s surgeon named Atul Gawande – checklists form the condensation point for interdisciplinary communication, allowing all team members to contribute to and understand the common goals and prioritize their work.

Of course, we will see how it works out but I have been fascinated by Gawande’s exposition and expect great results…